Researchers are struggling to explain why Quebec had the country's highest official COVID-19 death toll, but a relatively low number of excess deaths. A study — titled Excess mortality, COVID-19 and health-care systems in Canada — looked at excess deaths, which refers to when observed deaths exceed expectations based on previous years' data, between March 2020 and October 2021. Quebec only had 4,033 excess deaths in that period, despite reporting 11,470 COVID-19 fatalities — almost three times more. It's the biggest gap recorded in Canada during the pandemic.